Medical devices including distal chamber

ABSTRACT

Embodiments of the invention include an endoscope including a distal chamber and related methods of use, for example, with an endoscopic instrument.

CROSS-REFERENCE TO RELATED APPLICATION

This patent application is a continuation of U.S. application Ser. No.12/078,963, filed on Apr. 8, 2008, which claims the benefit of priorityunder 35 U.S.C. § 119 to U.S. Provisional Patent Application No.60/907,580, entitled ENDOSCOPES INCLUDING DISTAL CHAMBER AND RELATEDMETHODS OF USE, filed on Apr. 10, 2007, each of which is incorporatedherein by reference in its entirety.

DESCRIPTION OF THE INVENTION

Field of the Invention

Embodiments of the invention include an endoscope including a distalchamber and related methods of use, for example, with an endoscopicinstrument.

Background of the Invention

Endoscopes may be used with endoscopic instruments to treat the body.For example, an endoscope may be advanced into a patient's body lumen,such as a portion of a gastrointestinal tract like a colon. Anendoscopic instrument, for example, a biopsy forceps instrument, maythen be advanced down a working lumen of the endoscope, out a distal endof the endoscope, and into the gastrointestinal tract. The endoscope maythen be maneuvered to a particular portion of the colon from which atissue sample is desired, and the biopsy forceps instrument may thenobtain a tissue sample from the colon. Once the tissue sample has beenacquired, the biopsy forceps instrument may be retracted out of theendoscope, and the tissue sample may then be removed from the biopsyforceps instrument. The tissue sample is then placed in a container andlabeled. Once the tissue sample has been removed, the procedure may berepeated by advancing the biopsy forceps instrument back down theworking lumen of the endoscope into the gastrointestinal tract. Forexample, to diagnose inflammatory bowel disease, 20 or more tissuesamples may be required from the colon.

This procedure is time consuming, especially when using long, flexibleendoscopes, such as colonoscopes. Sometimes, multiple samples can beobtained during one passage of the biopsy forceps instrument through theendoscope lumen, by stacking samples inside the biopsy jaws.

SUMMARY OF THE INVENTION

An embodiment of the invention may include an endoscope. The endoscopemay include an elongate member, at least two lumens extending throughthe elongate member, and a chamber defined by a distal portion of theelongate member. A distal end of each of the at least two lumens mayterminate in the chamber.

Various embodiments of the invention may include one or more of thefollowing aspects: wherein the chamber is configured to accommodate adistal assembly of a medical instrument; wherein the chamber includes afirst seal at a distal end of the chamber and a second seal at aproximal end of the chamber.

Another embodiment of the invention may include an endoscope. Theendoscope may include an elongate member, an irrigation lumen and anaspiration lumen extending through the elongate member, and a chamberdefined by a distal portion of the elongate member. A distal end of eachof the irrigation lumen and the aspiration lumen may terminate in thechamber. The chamber may be configured to accommodate a distal assemblyof a medical instrument.

Various embodiments of the invention may include one or more of thefollowing aspects: wherein the distal ends of each of the irrigationlumen and the aspiration lumen are at an angle relative to alongitudinal axis of the elongate member; wherein the chamber includes afirst seal at a distal end of the chamber and a second seal at aproximal end of the chamber; wherein at least one of the irrigationlumen and the aspiration lumen includes a valve configured toselectively provide irrigation or aspiration, respectively, to eitherthe chamber or a body lumen; and wherein a distal end of at least one ofthe irrigation lumen and the aspiration lumen includes a nozzle-likeconfiguration or a flare-like configuration.

A further embodiment of the invention may include an endoscope. Theendoscope may include an elongate member, an irrigation lumen extendingthrough the elongate member, and a chamber defined by a distal portionof the elongate member. A distal end of the irrigation lumen mayterminate in the chamber. The chamber may be configured to accommodate adistal assembly of a medical instrument.

Various embodiments of the invention may include one or more of thefollowing aspects: wherein the chamber includes a first seal at a distalend of the chamber and a second seal at a proximal end of the chamber;wherein the chamber includes a first seal at a distal end of the chamberand a second seal on the medical instrument; wherein the irrigationlumen is configured to selectively provide irrigation to either thechamber or a treatment site; a sensor configured to detect an entranceof the distal assembly into the chamber; and wherein the irrigationlumen is configured to accommodate the medical instrument therethrough.

Yet another embodiment of the invention may include an endoscope. Theendoscope may include an elongate member, at least two lumens extendingthrough the elongate member, and a chamber defined by a distal portionof the elongate member. A distal end of each of the at least two lumensmay terminate in the chamber. A seal may be disposed between a distalend of at least one of the at least two lumens and the chamber.

Various embodiments of the invention may include the following aspect:wherein the chamber is configured to accommodate a distal assembly of amedical instrument.

A yet further embodiment of the invention may include an endoscope. Theendoscope may include an elongate member, at least two lumens extendingthrough the elongate member, and a chamber defined by a distal portionof the elongate member. A distal end of each of the at least two lumensmay terminate in the chamber. The chamber may include a first seal at adistal end of the chamber and a second seal at a proximal end of thechamber.

Various embodiments of the invention may include the following aspect:wherein the chamber is configured to accommodate a distal assembly of amedical instrument in an open configuration.

Still another embodiment of the invention may include a method. Themethod may include providing an endoscope including an elongate member,the elongate member including an irrigation lumen, an aspiration lumen,a working lumen, and a chamber defined by a distal portion of theelongate member, a distal end of each of the irrigation lumen, theaspiration lumen, and the working lumen terminating in the chamber,providing a medical instrument, advancing the elongate member of theendoscope through a body lumen, advancing the medical instrument throughthe working lumen of the endoscope, through the chamber, out of a distalend of the endoscope, and into the body lumen, obtaining a tissue samplewith the medical instrument, placing the tissue sample in the chamber,and removing the medical instrument and the endoscope from the bodylumen.

Various embodiments of the invention may include one or more of thefollowing aspects: providing irrigation fluid to the chamber via theirrigation lumen; providing suction to the aspiration lumen so as toaspirate the tissue sample from the chamber; providing irrigation fluidto the chamber via the irrigation lumen; placing the tissue sample in acollection container without removing the medical instrument from theendoscope; wherein the step of placing the tissue sample occurs afterthe step of providing suction to the aspiration lumen; wherein thedistal ends of each of the irrigation lumen and the aspiration lumen areat an angle relative to a longitudinal axis of the elongate member;wherein the chamber includes a first seal at a distal end of the chamberand a second seal at a proximal end of the chamber; advancing themedical instrument through the first seal and the second seal; obtaininga second tissue sample without removing the medical instrument from theendoscope; selectively irrigating at least one of the chamber and thebody lumen via the irrigation lumen; selectively aspirating at least oneof the chamber and the body lumen via the aspiration lumen; and sensingan entrance of the medical instrument into the chamber.

A still further embodiment of the invention may include a method. Themethod may include providing an endoscope including an elongate member,the elongate member including an aspiration lumen, a working lumen, anda chamber defined by a distal portion of the elongate member, a distalend of each of the aspiration lumen and the working lumen terminating inthe chamber, providing a medical instrument including a distal assembly,advancing the elongate member of the endoscope through a body lumen,advancing the distal assembly of the medical instrument through theworking lumen of the endoscope, through the chamber, out of a distal endof the endoscope, and into the body lumen, obtaining a tissue samplewith the distal assembly, retracting the medical instrument so as toplace the distal assembly and the tissue sample in the chamber, andremoving the medical instrument and the endoscope from the body lumen.

Various embodiments of the invention may include one or more of thefollowing aspects: providing suction to the aspiration lumen so as toaspirate the tissue sample from the chamber; wherein the chamberincludes a first seal at a distal end of the chamber and a second sealat a proximal end of the chamber; advancing the distal assembly throughthe first seal and the second seal; further comprising obtaining asecond tissue sample without removing the medical instrument from theendoscope; placing the tissue sample in a collection container withoutremoving the medical instrument from the endoscope; wherein the step ofplacing the tissue sample occurs after the step of providing suction tothe aspiration lumen; selectively aspirating at least one of the chamberand the body lumen via the aspiration lumen; and sensing an entrance ofthe distal assembly into the chamber.

Another embodiment of the invention may include a method. The method mayinclude providing an endoscope including an elongate member, theelongate member including an aspiration lumen, a working lumen, and achamber defined by a distal portion of the elongate member, a distal endof each of the aspiration lumen and the working lumen terminating in thechamber. The chamber may include a proximal seal disposed between thechamber and the working lumen and a distal seal disposed between thechamber and an outside environment. The method may further includeproviding a medical instrument including a distal assembly, advancingthe elongate member of the endoscope through a body lumen, advancing thedistal assembly of the medical instrument through the working lumen ofthe endoscope, through the proximal seal, through the chamber, throughthe distal seal, out of a distal end of the endoscope, and into the bodylumen, obtaining a tissue sample with the distal assembly of the medicalinstrument, retracting the distal assembly through the distal seal so asto place the distal assembly of the medical instrument and the tissuesample in the chamber, and removing the medical instrument and theendoscope from the body lumen.

Various embodiments of the invention may include one or more of thefollowing aspects: providing suction to the aspiration lumen so as toaspirate the tissue sample from the chamber; placing the tissue samplein a collection container without removing the medical instrument fromthe endoscope; wherein the step of placing the tissue sample occursafter the step of providing suction to the aspiration lumen; obtaining asecond tissue sample without removing the medical instrument from theendoscope; selectively aspirating at least one of the chamber and thebody lumen via the aspiration lumen; and sensing an entrance of thedistal assembly into the chamber.

Additional objects and advantages of the invention will be set forth inpart in the description which follows, and in part will be obvious fromthe description, or may be learned by practice of the invention. Theobjects and advantages of the invention will be realized and attained bymeans of the elements and combinations particularly pointed out in theappended claims.

It is to be understood that both the foregoing general description andthe following detailed description are exemplary and explanatory onlyand are not restrictive of the invention, as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention andtogether with the description, serve to explain the principles of theinvention.

FIG. 1 is a schematic view of an endoscope according to an embodiment ofthe invention. FIG. 1 also includes an endoscopic instrument disposedthrough the endoscope.

FIG. 2 is a schematic cross-sectional view of a distal portion of theendoscope of FIG. 1.

FIG. 3 is a schematic view of a proximal portion of the endoscope ofFIG. 1.

FIG. 4 is a schematic cross-sectional view of a distal portion of theendoscope of FIG. 1.

FIG. 5 is a schematic view of a distal assembly of an endoscopicinstrument disposed in the distal portion of FIG. 2 of the endoscope ofFIG. 1.

FIG. 6 is a schematic cross-sectional view of a distal portion of anendoscope according to another embodiment of the invention.

FIG. 7 is a schematic view of a distal portion of an endoscope accordingto a further embodiment of the invention.

FIG. 8 is a schematic view of an endoscope and a biopsy instrumenttherein, according to still another embodiment of the invention and thedistal portion of FIG. 7.

FIG. 9 is a schematic view of a handle portion of an endoscope accordingto yet another embodiment of the invention.

FIG. 10 is a schematic view of a distal portion of an endoscopeaccording to a still further embodiment of the invention.

FIG. 11 is a schematic cross-sectional view of a distal portion of anendoscope and a distal assembly of an endoscopic instrument according toa yet further embodiment of the invention.

FIGS. 12A-12C are schematic cross-sectional views of a distal portion ofan endoscope according to another embodiment of the invention.

FIG. 13 is a schematic cross-sectional view of a distal portion of anendoscope and a distal assembly of an endoscopic instrument according toa further embodiment of the invention.

FIG. 14 is a schematic cross-sectional view of a distal portion of anendoscope and a distal assembly of an endoscopic instrument according toyet another embodiment of the invention.

FIGS. 15A-15C are schematic cross-sectional views of a distal portion ofan endoscope and a distal assembly of an endoscopic instrument accordingto still another embodiment of the invention.

FIG. 16 is a schematic, exploded, cross-sectional view of a distalportion of an endoscope and a distal assembly of an endoscopicinstrument according to a yet further embodiment of the invention.

FIG. 17 is a schematic cross-sectional view of a distal portion of anendoscope and a distal assembly of an endoscopic instrument according toa still further embodiment of the invention.

FIGS. 18A-18B are schematic cross-sectional views of a distal assemblyof an endoscopic instrument according to another embodiment of theinvention.

DESCRIPTION OF THE EMBODIMENTS

Reference will now be made in detail to exemplary embodiments of theinvention, examples of which are illustrated in the accompanyingdrawings. Wherever possible, the same reference numbers will be usedthroughout the drawings to refer to the same or like parts.

FIGS. 1-4 depict an exemplary embodiment of an endoscope 1. Endoscope 1may include a handle portion 10, an elongate member 20, and a distalportion 100, however, endoscope 1 may have any other suitable endoscopiccomponents and/or configurations.

Elongate member 20 may have a plurality of lumens 21 runningtherethrough, for example, an irrigation lumen, an aspiration lumen, anda working lumen. Each lumen 21 may have a proximal end 22 and a distalend 23. Elongate member 20 may be configured to have an endoscopicinstrument 30 extending therethrough, for example, through lumen 21between proximal end 22 and distal end 23. Each lumen 21 within elongatemember 20 may mate with a corresponding portion of distal portion 100.Distal portion 100 may be integrally formed with elongate member 20.

Endoscopic instrument 30 may include distal assembly 31, for example, abiopsy forceps device having a pair of jaws for obtaining a tissuesample.

Endoscope 1 may also including a viewing lumen 221, as shown in FIG. 4,extending through elongate member 20 and extending to handle portion 10.Viewing lumen 221 may be configured, for example, to allow an operatorto view an operative site through distal end 23 using any suitablevisual apparatus and/or method.

An exemplary longitudinal cross-section of distal portion 100 ofendoscope 1 is shown in FIG. 2. Distal portion 100 may be removable fromelongate portion 20 of endoscope 1 or may be integrally formed withelongate member 20. Distal portion 100 may include one or more ofworking lumen 121 a, irrigation lumen 121 b, and aspiration lumen 121 c.In various embodiments, the functions of any irrigation lumen and anyaspiration lumen set forth in this application may be interchangeable(e.g., irrigation and/or aspiration may be conducted through anyirrigation lumen, and irrigation and/or aspiration may be conductedthrough any aspiration lumen). Each of working lumen 121 a, irrigationlumen 121 b, and aspiration lumen 121 c may include a respective distalend 123 a, 123 b, 123 c that terminates in a distal chamber 130. Distalchamber 130 may be bounded by a first seal 110 and a second seal 120,for example, on its distal and proximal ends, respectively. Distalportion 100 may also include a sensor 140. Any portion of distal portion100 may be made of any suitable biocompatible materials, for example,rigid materials configured to resist deformation in a body lumen andwithout damaging the body lumen.

Working lumen 121 a may be substantially parallel to a longitudinal axisof elongate member 20 and/or distal portion 100. Working lumen 121 a maybe configured to allow endoscopic instrument 30 to be advancedtherethrough, for example, a distal assembly 31 including a biopsyforceps device. Working lumen 121 a may be have a substantially circularcross-section, however, working lumen 121 a may have any suitable shape,size, and/or configuration. Distal assembly 31 of endoscopic instrument30 may be inserted through a proximal end 122 a of working lumen 121 aand emerge in distal chamber 130 via distal end 123 a.

Although the illustrated embodiment of endoscope 1 is depicted as havingone working lumen 121 a, those having ordinary skill in the art willreadily appreciate that endoscope 1 may include a plurality of workinglumens or channels. For example, it is contemplated that endoscope 1 maybe configured as a two-channel endoscope, so as to facilitatesimultaneous insertion of a plurality of endoscopic instruments 30. Inthose embodiments where endoscope 1 includes a plurality of workinglumens or channels, distal chamber 130 may be appropriately configuredto be in communication with each of the plurality of working lumens orchannels. For example, in those embodiments where endoscope 1 isconfigured as a two-channel endoscope, distal chamber 130 may be madelarger to be in communication with both working channels.

Most of each of irrigation lumen 121 b and aspiration lumen 121 c may besubstantially parallel to a longitudinal axis of elongate member 20,distal portion 100, and/or working lumen 121 a. Most of each ofirrigation lumen 121 b and aspiration lumen 121 c may also besubstantially parallel to each other. Each of irrigation lumen 121 b andaspiration lumen 121 c may have a substantially circular cross-section,however, each of irrigation lumen 121 b and aspiration lumen 121 c mayhave any suitable shape, size, and/or configuration.

Irrigation lumen 121 b may be configured to facilitate fluid flowtherethrough, for example, from a proximal end 122 b to distal end 123 band into distal chamber 130. Proximal end 122 b may be configured to beattached to a source of fluid 40, for example, as shown in FIG. 3. Aportion of irrigation lumen 121 b proximal to distal end 123 b may becurved so that lumen 121 b leads to chamber 130. A line normal to aplane defining distal end 123 b may form an angle with a longitudinalaxis of one or more of elongate member 20, distal portion 100, and/orworking lumen 121 a, for example, substantially a right angle. Distalend 123 b of irrigation lumen 121 b may have a narrow exit, beconfigured in the shape of a nozzle (e.g., decreasing in cross-sectionaldiameter closer to chamber 130), and/or have any other configuration toalter fluid flow, for example, into chamber 130.

Aspiration lumen 121 c may be configured to facilitate suction and/orfluid flow therethrough, for example, to remove a tissue sample 32and/or fluid from distal chamber 130, through distal end 123 c, and to aproximal end 122 c. Proximal end 122 c may be configured to be attachedto a source of suction 50 and/or a container 60 configured, for example,to collect tissue samples 32, for example, as shown in FIG. 3. Source ofsuction 50 and container 60 may be arranged in any suitableconfiguration. A portion of aspiration lumen 121 c proximal to distalend 123 c may be curved so that lumen 121 c leads to chamber 130. A linenormal to a plane defining distal end 123 c may form an angle with alongitudinal axis of one or more of elongate member 20, distal portion100, and/or working lumen 121 a, for example, substantially a rightangle. Distal end 123 c of aspiration lumen 121 c may be configured toease fluid flow and/or entry of biopsy sample 32 from chamber 130, forexample, by being flared (e.g., increasing in cross-sectional diametercloser to chamber 130).

The flow of fluid within irrigation lumen 121 b and aspiration lumen 121c may be in substantially opposite directions. For example, fluid mayflow through irrigation lumen 121 b in a substantially distal directionwhile fluid and/or tissue samples may flow through aspiration lumen 121c in substantially a proximal direction. Fluid flow through irrigationlumen 121 b and aspiration lumen 121 c may be independently operatedsuch that they are in operation at the same time, or at different times(e.g., staggered flow). For example, fluid may flow to distal chamber130 via irrigation lumen 121 b prior to aspiration being conducted viaaspiration lumen 121 c, so as to float tissue sample 32 in fluid andallow it to be more easily aspirated out of distal chamber 130. Thefluid flowing from irrigation lumen 121 b to aspiration lumen 121 c mayserve as both a carrier to advance tissue sample 32 through aspirationlumen 121 c to container 60 and a lubricant to reduce friction between awall of aspiration lumen 121 c and tissue sample 32.

Distal chamber 130 may have a substantially cylindrical shape, and maybe in flow communication with one or more of working lumen 121 a,irrigation lumen 121 b, and aspiration lumen 121 c via respective distalends 123 a, 123 b, 123 c. For example, distal chamber 130 may beconfigured to receive endoscopic instrument 30 from working lumen 121 avia distal end 123 a, fluid from irrigation lumen 121 b via distal end123 b, and/or suction from aspiration lumen 121 c via distal end 123 c.Distal chamber 130 may sized to surround an entirety of distal assembly31 of endoscopic instrument 30, for example, a portion of a biopsyforceps device that includes an acquired tissue sample 32. Distalchamber 130 may also be sized to accommodate distal assembly 31 in anopen configuration such that an acquired tissue sample 32 may be removedfrom endoscopic instrument 30, for example, as shown in FIG. 5. Invarious embodiments, however, distal chamber 130 may have any suitableshape, size, and/or configuration. For example, at least a portion ofdistal chamber 130 may have a cross-sectional area substantially thesame as endoscopic instrument 30 in a closed configuration. Thus, whenendoscopic instrument 30 is withdrawn into distal chamber 130 andcontacts the aforementioned portion of distal chamber 130, such physicalcontact may provide a tactile indication to a user that endoscopicinstrument 30 is disposed in distal chamber 130.

First seal 110 may be disposed between distal chamber 130 and theoutside environment (e.g., a treatment site within a body lumen), andmay have any suitable configuration and may be made of any suitablebiocompatible material. First seal 110 may also be disposed betweendistal ends 123 a, 123 b, 123 c of respective working lumen 121 a,irrigation lumen 121 b, and/or aspiration lumen 121 c and the outsideenvironment. Distal assembly 31 of endoscopic instrument 30 may bepassed from distal chamber 130 to the outside environment through firstseal 110, for example, via a perforation 111 in first seal 110, such asslits in an elastomeric seal. When endoscopic instrument 30 is disposedthrough first seal 110, first seal 110 may form a substantially fluidtight fit around a portion of endoscopic instrument 30, for example, toprevent fluid flow into and/or out of distal chamber 130 via first seal110. First seal 110 may be configured to inhibit fluid flow betweendistal chamber 130 and the outside environment, for example, whenaspiration lumen 121 c is performing aspiration on distal chamber 130,whether or not endoscopic instrument 30 is disposed through first seal110. Fluid flowing from irrigation lumen 121 b into distal chamber 130may be inhibited from flowing to the outside environment by first seal110, also whether or not endoscopic instrument 30 is disposed throughfirst seal 110.

Second seal 120 may be disposed between distal chamber 130 and distalend 123 a of working lumen 121 a, and may have any suitableconfiguration and may be made of any suitable biocompatible material.Second seal 120 may also be disposed between distal ends 123 b, 123 c ofrespective irrigation lumen 121 b and/or aspiration lumen 121 c anddistal end 123 a of working lumen 121 a. Distal assembly 31 ofendoscopic instrument 30 may be passed into distal chamber 130 throughsecond seal 120, for example, via a perforation 121 in second seal 120,such as slits in an elastomeric seal. When endoscopic instrument 30 isdisposed through second seal 120, second seal 120 may form asubstantially fluid tight fit around a portion of endoscopic instrument30, for example, to prevent fluid flow into and/or out of distal chamber130 via second seal 120. Second seal 120 may be configured to inhibitfluid flow between distal chamber 130 and working lumen 121 a, forexample, when aspiration lumen 121 c is performing aspiration on distalchamber 130, whether or not endoscopic instrument 30 is disposed throughsecond seal 120. Fluid flowing from irrigation lumen 121 b into distalchamber 130 may be inhibited from flowing into working lumen 121 a bysecond seal 120, also whether or not endoscopic instrument 30 isdisposed through second seal 120.

First seal 110 and second seal 120 may be configured to prevent air orother fluids from the outside environment and/or working lumen 121 afrom entering distal chamber 130, for example, while aspiration lumen121 c is removing air, fluid, and/or tissue samples from distal chamber130. Accordingly, suction from distal chamber 130 via aspiration lumen121 c may be enhanced. First seal 110 and second seal 120 may also oralternatively be configured to prevent fluid and/or biopsy samples fromexiting distal chamber 130 to the outside environment and/or workinglumen 121 a.

First seal 110 and second seal 120 may be made out of any suitablebiocompatible material, for example, an elastomer, silicone, orpolyurethane. Some examples of seals include RX (Rapid Exchange) LOCKINGDEVICE AND BIOPSY CAP SYSTEM™ manufactured by BOSTON SCIENTIFICCORPORATION™ or any of its subsidiaries.

Sensor 140 may be configured to allow a user to determine when distalassembly 31 of endoscopic instrument 30 is no longer disposed in theoutside environment, and instead is disposed in distal chamber 130. Forexample, sensor 140 may be coupled to one or more of distal chamber 130,first seal 110, and second seal 120 to provide audio or visual feedbackto the user by detecting the presence of distal assembly 31 in distalchamber 130 using any suitable method. Some suitable sensors 140 mayinclude a sensor which utilizes magnets (e.g., to produce a Halleffect), broken light beams, or RFID sensors. However, any suitablesensor 140 may be used. Sensor(s) 140 may located on any suitableportion of endoscope 1 and/or endoscopic instrument 30 depending on thetype of sensor used.

In the alternative, the user may be provided with sufficient tactilefeedback when the distal assembly 31 enters distal chamber 130 so as tomake sensor 140 unnecessary. For example, the user may be able to feelon the proximal end of endoscopic instrument 30 when distal assembly 31completely enters distal chamber 130 because distal assembly 31 will nolonger be disposed through, and hence disengage from, first seal 110.

In a further embodiment where sensor(s) 140 may not be necessary,endoscopic instrument 30 may have visual markers or other indicators onits proximal end. Such visual markers or other indicators may beconfigured such that when endoscopic instrument 30 is disposed in distalchamber 130, the visual marker or other indicators emerge from proximalend 122 a of working lumen 121 a.

FIG. 10 depicts an exemplary embodiment of endoscope 1 including one ormore valves 70. Valves 70 may be configured to selectively directirrigation and/or suction to/from at least one of the outsideenvironment and distal chamber 130. For example, endoscope 1 may includeirrigation valve 70 a and aspiration valve 70 b.

Irrigation valve 70 a may be disposed in irrigation lumen 121 b and maybe configured to, in a first position, allow fluid flow from irrigationlumen 121 b to chamber 130 and at least partially prevent fluid flowfrom irrigation lumen 121 b to the outside environment via irrigationextension 124 b, and, in a second position, allow fluid flow fromirrigation lumen 121 b to the outside environment via irrigationextension 124 b and at least partially prevent fluid flow fromirrigation lumen 121 b to chamber 130. In FIG. 10, irrigation valve 70 ais disposed in the first position. Accordingly, a user may selectivelyirrigate either chamber 130 or the outside environment depending on theposition of irrigation valve 70 a.

Aspiration valve 70 b may be disposed in aspiration lumen 121 c and maybe configured to, in a first position, allow suction from chamber 130 toaspiration lumen 121 c and prevent suction from the outside environmentto aspiration lumen 121 c via aspiration extension 124 c, and, in asecond position, allow suction from the outside environment toaspiration lumen 121 c via aspiration extension 124 c and substantiallyprevent suction from chamber 130 to aspiration lumen 121 c. In FIG. 10,aspiration valve 70 b is disposed in the second position. Accordingly, auser may selectively suction either chamber 130 or the outsideenvironment depending on the position of aspiration valve 70 b.

Valves 70 may be any suitable valves and may be selectively and/orindependently actuated using any suitable control mechanism. Forexample, valves 70 may be a poppet or flapper type valve that isconnected to an actuation wire that runs along and/or through elongatemember 20 to handle portion 10. In another example, valves 70 may beminiaturized solenoid valves actuated using any suitable method, forexample, electrical, infrared, or wireless structures. Handle portion 10may have suitable actuators for the user to actuate valves 70 into theappropriately desired position. One advantage of valves 70 may be thatit may reduce the number of lumens in endoscope 1 by allowing irrigationlumen 121 b to provide fluid to both the outside environment and chamber130. The same is true for aspiration lumen 121 c and suction. In analternative embodiment, sliding windows may be used to selectivelycontrol fluid flow and/or biopsy sample suction into and out ofirrigation lumen 121 b and/or aspiration lumen 121 c. For example, asliding window may be configured to slide distally to cover distal end123 b, 123 c of lumen 121 b, 121 c, and proximally to uncover them.

Endoscope 1 and endoscopic instrument 30 may be configured such thatendoscopic instrument 30 is disposed at a particular circumferentialorientation or range of circumferential orientations relative toendoscope 1. For example, chamber 130 may have a substantiallyoval-shape, as shown in FIG. 11, such that distal assembly 31 ofendoscopic instrument 30 may be placed in an open configuration in asmall range of circumferential orientations. This may be desirable, forexample, such that irrigation lumen 121 b and aspiration lumen 121 c maybe most ideally positioned relative to distal assembly 31 to removetissue sample 32 from chamber 130. Any suitable configurations and/orstructures may be used to achieve this effect. For example, workinglumen 121 a and/or chamber 130 may include a protrusion and the outsideof endoscopic instrument 30 may include a groove configured to receivethe protrusion such that the protrusion will only fit in the groove in alimited number of circumferential orientations.

In another exemplary embodiment depicted in FIGS. 12A-12C, the endoscopemay include distal chamber 630 surrounded by one or more lumens 621 b.Lumens 621 b may be in flow communication with distal chamber 630 viachannels 622 b. One or more of lumens 621 b may have tubes 623 b, 623 cdisposed therein that are longitudinally movable relative to distalchamber 630 and lumens 621 b. Tubes 623 b, 623 c may be configured toconduct irrigation and/or aspiration, for example, tube 623 b may be anirrigation tube and tube 623 c may be an aspiration tube. Tubes 623 b,623 c may include curved portions 624 b, 624 c configured, for example,to enter channels 622 and face distal chamber 630 as shown in FIG. 12B.Curved portions 624 b, 624 c may be flexible enough such that when movedproximally (as shown in FIG. 12A) or distally (as shown in FIG. 12C)relative to channels 622, curved portions 624 b, 624 c becomesubstantially straight. In the configuration shown in FIG. 12C, tubes623 b, 623 c may be configured to conduct irrigation and/or aspirationwith the outside environment. Tubes 623 b, 623 c may be jointly and/orindependently movable relative to each other, and in some embodiments,only one of tubes 623 b, 623 c may be deployed in lumens 621 b, with theother lumen 621 b conducting irrigation and/or aspiration as necessary.Tubes 623 b, 623 c may be actuated to attain a curved shape at portions624 b, 624 c through any suitable means, such as use of a pull wire orthrough the material used (e.g., shape memory material).

In various embodiments, endoscope 1 may have any number of seals on anyportion of endoscope 1 and/or endoscopic instrument 30. For example, asshown in FIG. 13, seal 520 may be placed on endoscopic instrument 30proximal to distal assembly 31. Seal 520 may cooperate with theinterface between working lumen 121 a and distal chamber 130 to at leastpartially prevent fluid flow therethrough and/or seal 520 may have across-sectional area substantially similar to distal chamber 130 so asto at least partially prevent fluid flow therepast.

Any seal set forth herein may have any suitable shape. For example, FIG.14 depicts seal 820 having a substantially cup-shaped configuration.Such a configuration may be advantageous, for example, in at leastpartially preventing fluid flow therethrough from distal chamber 130into working lumen 121 a.

In a further embodiment, endoscopic instrument 930 may be provided inmultiple pieces. For example, as shown in FIGS. 15A-15C, endoscopicinstrument 930 may include elongate portion 933 and distal assembly 931that are detachable from each other. Elongate portion 933 may bedisposed in working lumen 121 a. Distal assembly 931 may be introducedthrough distal end 23 of endoscope 1 and attached to a distal end ofelongate portion 933. Distal assembly 931 may have a cross-sectionalarea such that it may fit within distal chamber 130, but would not fitwithin working lumen 121 a. A proximal end of elongate portion 933 maybe configured to be attached to a handle portion configured tomanipulate distal assembly 931 via elongate portion 933. Examples ofadvantages of endoscopic instrument 930 are set forth in U.S. PatentApplication Publication No. 2003/0105488 A1 published on Jun. 5, 2003,the entirety of which is incorporated herein by reference.

In another embodiment, endoscopic assembly 800 may include multipleinterlocking portions. For example, as shown in FIG. 16, endoscopicassembly 800 may include one or more of distal cap 801, tubes 821 b, 821c configured to accommodate irrigation and/or aspiration, distalassembly 31 of endoscopic instrument 30, and endoscope 802 definingworking lumen 821 a. Distal cap 801 may include seal 810 with slit 811,outer housing 813 defining distal chamber 830, and attachment portion812 configured to attach distal cap 801 to one or more of tubes 821 b,821 c and endoscope 802. Attachment portion 812 may provide sufficientattachment to tubes 821 b, 821 c and/or endoscope 802 so as to preventdetachment due to pressures in distal chamber 830 associated withirrigation and/or aspiration. Tubes 821 b, 821 c may include distalportion 824 b, 824 c configured to curve inward so as to provideirrigation and/or aspiration to distal chamber 830 when endoscopicassembly 800 is fully assembled. Endoscope 801 may include illuminationportion 842 and visualization portion 841 on its distal end that mayoperate by providing illumination and/or visualization through outerhousing 813 of distal cap 801 either through apertures in outer housing813, or outer housing 813 being made of a transparent material.

In a further embodiment, endoscope 1000 may only include working lumen1021 a and aspiration lumen 1021 c as shown in FIG. 17. Endoscopicinstrument 30 may include a seal 1020 disposed therearound. Seal 1020may be configured to have a cross-sectional area substantially similarto a cross-sectional area of working lumens 1021 a. Seal 1020 may beconfigured to cooperate with inner surface 1070 of endoscope 1000 toform a substantially airtight seal such that when aspiration isconducted through aspiration lumen 1021 c, enough of a vacuum is createdin distal chamber 1030 such that tissue sample 32 may be aspirated outof distal chamber 1030 via aspiration lumen 1021 c.

An embodiment of the invention may include a method of using anendoscope and endoscopic instrument, for example, endoscope 1 andendoscopic instrument 30 as set forth in FIGS. 1-4.

In the method, endoscope 1 may be provided, proximal end 122 b ofirrigation lumen 121 b may be connected to a source of fluid 40, andproximal end 122 c of aspiration lumen 121 c may be connected to sourceof suction 50 and container 60, for example, as shown in FIG. 3. Using avisual image provided by viewing lumen 221, shown in FIG. 4, elongatemember 20 of endoscope 1 may be advanced into a body lumen, for example,a gastrointestinal tract of a patient. Elongate member 20 may beadvanced until distal end 23 and/or distal portion 100 may besubstantially adjacent to a desired portion of the gastrointestinaltract, for example, a portion to be treated or a portion from which atissue sample 32 is desired.

Once so positioned, distal assembly 31 of endoscopic instrument 30 maybe advanced into working lumen 121 a via proximal end 122 a. Endoscopicinstrument 30 may be advanced through working lumen 121 a until distalassembly 31 reaches distal end 123 a. Distal assembly 31 of endoscopicinstrument 30 may then be advanced through second seal 120, for example,through perforation 121 and into distal chamber 130. Distal assembly 31of endoscopic instrument 30 may then be further advanced through distalchamber 130, through first seal 110 via perforation 111, and into thegastrointestinal tract. Once disposed in the gastrointestinal tract,endoscope 1 and distal assembly 31 may be repositioned in thegastrointestinal tract, and distal assembly 31 of endoscopic instrument30 may obtain tissue sample 32.

Once the tissue sample has been obtained, distal assembly 31 ofendoscopic instrument 30 may be retracted into distal chamber 130through perforation 111 of first seal 110. Once tissue sample 32 isdisposed in distal chamber 130, sensor 140 may detect that distalassembly 31 is completely disposed within distal chamber 130, andprovide audio or visual feedback to the user. Alternatively, theoperator may receive a tactile feedback indicating that distal assembly31 is in distal chamber 130. Consequently, fluid may flow into distalchamber 130 from fluid source 40 via proximal end 122 b, irrigationlumen 121 b, and distal end 123 b, for example, for about 5 seconds atbetween about 60 psi and 80 psi. Distal assembly 31 of endoscopicinstrument 30 may either release the tissue sample 32, as shown in FIG.5, or the fluid flowing into distal chamber 130 from irrigation lumen121 b may dislodge tissue sample 32 from endoscopic instrument 30.Tissue sample 32 may be released into any position in distal chamber130, for example, substantially adjacent to distal end 123 c ofaspiration lumen 121 c. First seal 110 may substantially prevent fluidfrom flowing out of distal chamber 130 and into the outside environment,and second seal 120 may substantially prevent fluid from flowing out ofdistal chamber 130 and into working lumen 121 a, for example, becausesecond seal 120 may form a substantially fluid tight seal aroundendoscopic instrument 30, also as shown in FIG. 5.

Suction may be initiated from suction source 50 such that gas(es),fluid(s), and tissue sample(s) 32 may be removed from distal chamber 130by flowing through distal end 123 c, aspiration lumen 121 c, andproximal end 122 c into container 60, for example, at about 15 in/Hg.First seal 110 may substantially prevent the application of suction tothe outside environment, and thereby prevent air from flowing intodistal chamber 130 from the outside environment, and second seal 120 maysubstantially prevent fluid from flowing into distal chamber 130 fromworking lumen 121 a, for example, because second seal 120 may form asubstantially air tight seal around endoscopic instrument 30.

Once the tissue sample(s) 32, gas(es), and/or fluid(s) have been removedfrom distal chamber 130, distal assembly 31 of endoscopic instrument 30may be advanced back into the outside environment through perforation111 of first seal 110 and another tissue sample 32 may be acquired.Distal assembly 31 of endoscopic instrument 30 may then again beretracted into distal chamber 130 and tissue sample 32 may be irrigatedvia fluid from fluid source 40 and aspirated to container 60 using anystep or steps set forth herein. Any combination of any of these stepsmay be repeated as many times as desired to obtain as many tissuesamples as desired.

Once the desired number of tissue samples 32 have been obtained,endoscopic instrument 30 may be retracted out of first seal 110, distalchamber 130, second seal 120, distal end 123 a, working lumen 121 a, andproximal end 122 a. Elongate member 20 of endoscope 1 may then beremoved from the gastrointestinal tract.

Endoscope 1 may be used in any suitable medical procedure in anysuitable portion of the body. Endoscopic instrument 30 may be anysuitable endoscopic instrument to perform any desired endoscopicprocedure, whether to obtain tissue samples 32 or otherwise. Forexample, endoscopic instrument 30 may include any suitable instrumentmanufactured and/or sold by BOSTON SCIENTIFIC CORPORATION™ or itssubsidiaries, for example, a RADIAL JAW 3 BIOPSY FORCEPS™ or RADIAL JAW4 BIOPSY FORCEPS™.

Distal assembly 100 of endoscope 1 may have alternative embodiments. Forexample, FIG. 2 shows a distal portion 100 wherein distal ends 123 b,123 c of irrigation lumen 121 b and aspiration lumen 121 c aresubstantially facing each other. However, in distal portion 300 as shownin FIG. 6, distal ends 323 b, 323 c of lumens 321 b, 321 c may bedisposed at different portions of distal chamber 130 such that they donot face each other. For example, distal end 323 b may be disposed at aproximal end (e.g., closer to second seal 120) of distal chamber 130while distal end 323 c may be disposed at a distal end (e.g., closer tofirst seal 110) of distal chamber 130. Lumens 321 b, 321 c may be anycombination of an irrigation lumen and an aspiration lumen. For example,lumen 321 b may be an irrigation lumen and lumen 321 c may be anaspiration lumen, such that fluid will flow into distal chamber 130 fromdistal end 323 b of irrigation lumen 321 b and distally push tissuesample 32 to distal end 323 c of aspiration lumen 321 c.

In various embodiments, endoscope 1 may have any number of lumens 21with any number of distal ends located in any portion of distal chamber130. Each distal end of various lumens may have any shape, size, orconfiguration, and any two distal ends of lumens 21 may have either thesame shapes, sizes, and configurations, or different shapes, sizes, andconfigurations. A single lumen 21 may even have more than one distal endin distal chamber 130. The distal ends of lumens 21 may enter distalchamber 130 at any suitable angle, in both the axial and radial planes.The distal ends of lumens 21 may be configured about distal chamber 130to achieve a specific flow profile, for example, turbulent flow orchaotic flow in distal chamber 130.

In another embodiment, FIGS. 7-8 show a distal portion 400 including anirrigation fluid bypass 421 b (i.e., irrigation lumen) with a proximalend 422 b connected to working lumen 421 a proximal to distal end 423 a.Distal ends 423 b, 423 c of irrigation lumen 421 b and aspiration lumen421 c may be connected to and/or be in flow communication with distalchamber 430 in any suitable configuration, for example, between firstseal 410 and second seal 420. Accordingly, fluid source 40 may beconnected to a proximal end 122 a of working lumen 421 a. When inoperation, fluid may flow from fluid source 40, through proximal end 122a, through working lumen 421 a, and come up against second seal 420. Atthis point, second seal 420 may or may not have an endoscopic instrument30 disposed therethrough. In any case, fluid from working lumen 421 amay be directed (e.g., by second seal 420) through proximal end 422 b ofwater bypass 421 b and into distal chamber 430 via distal end 423 b.

As shown in FIG. 8, fluid may flow to distal portion 400 via an elongatesheath 440 disposed around an elongate portion of endoscopic instrument30. A distal end 441 of elongate sheath 440 may be disposed proximal todistal chamber 430 and second seal 420, and proximal or adjacent toproximal end 422 b of irrigation lumen 421 b such that fluid may flowfrom elongate sheath 440 into irrigation lumen 421 b via proximal end422 b. A proximal portion 442 of elongate sheath 440 may include aY-connector (e.g., manufactured by QOSINA™) including a plurality oflumens 442 a, 442 b. Lumen 442 a may be configured to be connected to asource of fluid 40. Lumen 442 b may be configured to receive endoscopicinstrument 30 and may include a connector 450 (e.g., a Touhy-Borstconnector manufactured by QOSINA™) on a proximal end.

Connector 450 may be configured such that in a first configuration,endoscopic instrument 30 may move freely longitudinally relative toelongate sheath 440, for example, while distal assembly 31 is beingmoved relative to distal chamber 430 so as to acquire tissue sample 32and place tissue sample 32 in distal chamber 430. Connector 450 may beplaced in a second configuration so as to prevent endoscopic instrument30 from longitudinally moving relative to elongate sheath 440, forexample, by locking endoscopic instrument 30 to the portion of elongatesheath 440 defining lumen 442 b. At this time, connector 450 may alsoform a substantially fluid-tight seal so as prevent fluid from flowingproximally between elongate sheath 440 and endoscopic instrument 30 atproximal portion 442. Fluid may then be flowed through elongate sheath440 from a fluid source 40 via lumen 442 a. Fluid may be prevented fromflowing proximally past lumen 442 b by a combination of connector 450,elongate sheath 440, and endoscopic instrument 30. Fluid may thus flowdown elongate sheath 440 and out distal end 441 into working lumen 421 aand/or irrigation lumen 421 b. Fluid may flow from there into distalchamber 430 so as to float and/or carry tissue sample 32 toward distalend 423 c of aspiration lumen 421 c, and eventually sent to container60. An advantage to this configuration may be that space is saved and/ormanufacturing of endoscope 1 becomes less complicated due to theelimination of an irrigation lumen running an entire length of theelongate portion 20 of endoscope 1.

In a further embodiment, FIG. 9 depicts a handle portion 710 configuredto be connected to a source of fluid 740 and also including both asource of suction 750 and a container 760 for storing tissue samples732. Container 760 may either be removable from handle portion 710, orcontainer 760 may be configured to allow tissue samples 732 to beremoved from container 760, for example, by including a door or othermeans to access the samples 732. Proximal end 722 b of irrigation lumen721 b may be attached to fluid source 740, and proximal end 722 c ofaspiration lumen 721 c may be attached to any combination and/orconfiguration of suction source 750 and container 760. Other examples ofsuitable devices and/or configurations for storing and removing tissuesamples are set forth in U.S. Pat. No. 6,926,676 B2 issued Aug. 9, 2005to Vincent TURTURRO et al, the entirety of which is incorporated hereinby reference.

Any aspects of any of the embodiments set forth herein may be combinedin any suitable combination. For example, distal assembly 100 mayinclude a proximal end 22 as set forth in FIG. 3 and/or a handle portion710 as set forth in FIG. 9. In another example, endoscope 1 may includeany of distal portions 100, 300, or 400.

Any suitable part may be used for any aspect set forth herein and mayhave any suitable size, shape, and/or configuration. For example, theportion of the aspiration lumen disposed in the elongate member of theendoscope proximal to the distal portion may be a ARKEMA PEBAX 7233 SN01 Polyether Block Amide having an inner diameter of about 0.07 inches,an outer diameter of about 0.09 inches, and a length of about 240 cm. Ina further example, the portion of the irrigation lumen disposed in theelongate member of the endoscope proximal to the distal portion may bemanufactured by ENDOVATIONS™. In another example, the endoscope may bemade of PELLETHANE 55D RESIN and have an inner diameter if about 0.11inches, an outer diameter of about 0.15 inches, and a length of about190 cm. In yet another example, the source of suction may be a suctionpump manufactured by MEDICAL SPECIFICS.

Any suitable device may be used in conjunction with endoscope 1. Forexample, endoscopic instrument 30 may be any medical instrumentincluding, but not limited to, biopsy forceps, baskets, graspers,snares, and/or needles. An example of an endoscopic instrument 230 isset forth in FIGS. 18A-18B. Endoscopic instrument 230 includes distalforceps 231 including apertures 232 extending through distal forceps231. Accordingly, in operation, forceps 231 may be used to acquiretissue which then may be disposed in apertures 232. Forceps 231 may thenbe placed in distal chamber 130 as set forth in FIGS. 1-4 in anorientation such that apertures 232 are substantially in line withdistal ends 123 b, 123 c of irrigation and aspiration lumens 121 b, 121c. Fluid may then be run through irrigation lumen 121 b into distalchamber 130 and through apertures 232 to dislodge the acquired tissuesample. The tissue sample may then be aspirated by aspiration lumen 121c. In some embodiments, the fluid pressure from irrigation lumen 121 band/or vacuum pressure from aspiration lumen 121 c may be sufficient todislodge the tissue from forceps 231, either through apertures 232 ordirectly from the teeth of forceps 231, without opening forceps 231 oronly partially opening forceps 231.

There are many advantages to the various embodiments set forth in thisapplication. For example, multiple tissue samples may be acquiredwithout removing endoscopic instrument 30 and particularly its distalassembly 31, from endoscope 1. As a result, more tissue samples may beacquired in less time. There also is less risk of cross-contamination ofsamples, as compares to a prior method of stacking multiple sampleswithin the biopsy jaws. In addition, there is less risk of contaminationand infection due to continually removing and reinserting endoscopicinstrument 30.

In various embodiments, the invention may include providing a kit wherean endoscopic instrument 30 is already disposed in endoscope 1. Distalassembly 31 may be disposed in distal chamber 130 such that a user maypurchase the kit with endoscopic instrument 30 already disposed inendoscope 1, and immediately use the kit by advancing endoscope 1 intothe body. Such a kit may be advantageous because it reduces the numberof steps in an endoscopic procedure, i.e., the step of advancing theendoscope instrument 30 through endoscope 1. In some embodiments, distalassembly 31 may be integrated with endoscope 1 in distal chamber 130,and only pull wires or other actuations means may be disposed the lengthof endoscope 1, for example, through working lumen 121 a.

Other embodiments of the invention will be apparent to those skilled inthe art from consideration of the specification and practice of theinvention disclosed herein. It is intended that the specification andexamples be considered as exemplary only, with a true scope and spiritof the invention being indicated by the following claims.

What is claimed is:
 1. A medical device, comprising: a shaft having aproximal end, a distal end, and a length extending between the proximalend and the distal end; a plurality of lumens extending along the lengthof the shaft; and a chamber defined by a hollow portion of the shaft,wherein the chamber is located within a distal region of the shaft; anda seal located at a distal end of the chamber, wherein the seal isconfigured to transition between an open configuration and a closedconfiguration, and wherein the seal is biased in the closedconfiguration; wherein each of the plurality of lumens is fluidlycoupled with the chamber.
 2. The medical device of claim 1, wherein theseal defines a distal end of the chamber.
 3. The medical device of claim1, wherein the seal defines at least a portion of a distal face of theshaft.
 4. The medical device of claim 1, wherein a first lumen of theplurality of lumens extends to, and fluidly connects with, a proximalend of the chamber.
 5. The medical device of claim 4, wherein a secondseal is located between a distal end of the first lumen and a proximalregion of the chamber, and wherein the second seal is configured totransition between an open configuration and a closed configuration, andwherein the second seal is biased in the closed configuration.
 6. Themedical device of claim 4, wherein a bypass lumen extends from a distalregion of the first lumen to a side region of the chamber, fluidlycoupling the distal region of the first lumen with the chamber.
 7. Themedical device of claim 1, wherein a first lumen of the plurality oflumens extends to, and fluidly couples with, a side of the chamberlocated between a proximal end and a distal end of the chamber.
 8. Themedical device of claim 7, wherein a second seal is located between thefirst lumen and the side of the chamber.
 9. The medical device of claim1, wherein each of a first lumen and a second lumen of the plurality oflumens extends to, and fluidly couples with, a region of the chamberbetween a proximal end of the chamber and the distal end of the chamber.10. The medical device of claim 9, wherein an end of the first lumen andan end of the second lumen couple with the chamber so that the end ofthe first lumen and the end of the second lumen are both spaced a samedistance from the proximal end of the chamber and the distal end of thechamber.
 11. The medical device of claim 9, wherein an end of the firstlumen couples with the chamber at a region closer to the proximal end ofthe chamber relative to where an end of the second lumen couples withthe chamber.
 12. The medical device of claim 1, wherein a first lumen ofthe plurality of lumens extends to the distal end of the shaft, whereina portion of the first lumen located proximal of the distal end of theshaft is fluidly coupled with a side region of the chamber.
 13. Themedical device of claim 12, wherein a second seal is located between theside region of the chamber and the portion of the first lumen fluidlycoupled with the side region of the chamber.
 14. A medical device,comprising: a shaft having a proximal end, a distal end, and a lengthextending between the proximal end and the distal end; a chamber definedby a hollow portion of the shaft, wherein the chamber is located withina distal region of the shaft; a first seal located at a distal end ofthe chamber, wherein the first seal is configured to transition betweenan open configuration and a closed configuration, and wherein the firstseal is biased in the closed configuration; a first lumen extendingthrough the shaft from the proximal end of the shaft to a proximal endof the chamber and fluidly coupled with the proximal end of the chamber;a second seal located between a distal end of the first lumen and thechamber, wherein the second seal at least partially defines the proximalend of the chamber, and wherein the second seal is configured totransition between an open configuration and a closed configuration, andwherein the second seal is biased in the closed configuration; and asecond lumen extending through the shaft, wherein a distal region of thesecond lumen is fluidly coupled with the chamber.
 15. The medical deviceof claim 14, further comprising a third lumen extending through theshaft, wherein a distal region of the third lumen is fluidly coupledwith the chamber.
 16. The medical device of claim 15, wherein the secondlumen is in aspiration lumen, and the third lumen is an irrigationlumen.
 17. The medical device of claim 14, wherein the second lumenextends to the distal end of the shaft.
 18. The medical device of claim14, wherein the second lumen ends where it couples with the chamber. 19.A medical device, comprising: a shaft having a proximal end and a distalend; a plurality of lumens within the shaft; a chamber defined by ahollow portion of the shaft, wherein the chamber is located within adistal region of the shaft; and a seal located at a distal end of thechamber, wherein the seal is configured to transition between an openconfiguration and a closed configuration, and wherein the seal is biasedin the closed configuration; wherein a distal region of each of theplurality of lumens is fluidly coupled with the chamber; wherein a firstlumen of the plurality of lumens extends from the proximal end of theshaft to the chamber; and wherein a second lumen of the plurality oflumens extends from a region distal of the proximal end of the shaft tothe chamber.
 20. The medical device of claim 19, wherein the secondlumen extends from a distal region of the first lumen to the chamber.